Basics Of Clinical Nutritions

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Preface to the First Edition

The need of nutritional therapy has been emphasized in the patient care, especially for hospitalized patients, where malnutrition related complications are on rise. Malnutrition has been reported in 30-80 percent of hospitalized patients and more so in surgical patients. This prolongs the therapeutic schedule, increases the hospital stay and also leads to high mortality and morbidity. Though nutritional intervention looks costly, it has been found to be overall cost effective. Moreover, there are several systemic diseases where there is no specific or definite treatment and patients have to be managed by supportive measures and in some instances life long. And provision of adequate amount of nutrition, the way it is accepted by the patient and in adequate quantity providing all the ingredients and calories becomes essential in such conditions.

Preface to the Second Edition

The need for nutritional therapy has been emphasized in the patient care, especially for hospitalized patients, where malnutrition related complications are on rise. Malnutrition has been reported in 30-80 percent of hospitalized patients. This prolongs the therapeutic schedule, increases the hospital stay and also leads to high mortality and morbidity. Moreover, there are several systemic and chronic diseases where there is no specific or definite treatment and patients have to be managed by supportive measures, in some instances  life  long . And provision of adequate amount of nutrition, the way it is accepted by the patient, providing all the ingredients and adequate calories becomes essential to maintain quality of life.

It is essential to understand difference between the consequences of malnutrition in health and diseases in order to understand the need of nutritional supplements. It is also necessary to understand the need and importance of various nutrients and their role in different diseases. One should also know how to assess a patient’s nutritional status, nutritional needs, and how to provide it, so that, it is not over done and does not bring any harm to the patient. Many outstanding discoveries and techniques in developed countries have revolutionized nutrition support during the last few decades, which include long term parenteral nutrition, amino acid preparations, intravenous fat supplements, improved vascular and enteral access and devices, early enteral nutrition and immunonutrition. Over the past few decades a new outlook has emerged through a number of studies clearly demonstrating the positive results of nutritional support. Recently some evidence-based guidelines have been developed for nutritional support in acute and chronic diseases. All in all we have ample evidence that lack of nutrition leads to a poorer quality of life, higher morbidity and mortality, increased hospitalization, frequent re-admissions and delayed recovery, that in turn lead to higher hospital costs. Notwithstanding the huge strides made in research and development, clinical nutrition is still in its infancy in India and we have a long way to go to match international standards. 

Contents

  1. The Rationale for Nutritional Support and Organization of a Nutrition Support Service-

                                                                                                                     K Sriram, Eva Panizales

  1. Food and Nutrient Requirements –

                                                                                                                                    Amita Attlee, Kajal Jain

  1. Assessment of Nutritional Status-

                                                                                                                                    Mamta Srivastava

  1. Assessment of Nutritional Status in Clinical Practice –

                                                                                                                                    Jaya Benjamin

  1. Carbohydrates, Proteins and Fats-

                                                                                                                                    Namrata Singh

  1. Vitamins –

                                                                                                                                     Nandini Srivastava

  1. Energy in Health and Disease-

                                                                                                                                     Varsha

  1. Starvation, Stress and Disease: Consequences-

                                                                                                                                      Varsha

  1. Enteral Nutrition: A Comprehensive Overview-

                                                                                                                                     YK Joshi, M Joshi

  1. Parenteral Nutrition: An Overview-

                                                                                                                                    YK Joshi, Jaya Benjamin

  1. Trace Elements in Parenteral and Enteral Nutritional Support-

                                                                                                                                    K Sriram

  1. Parenteral and Enteral Nutrition in Surgical Patients 203

K Sriram

  1. Nutritional Support in Stress and Injury-

                                                                                                                                    Pravin Amin

  1. Nutritional Support in the Critically Ill Patient –

                                                                                                      Ram E Rajagopalan, R Rajaram, S Mahendran

  1. Nutrition and Cardiovascular Disease-

                                                                                                      Shiv Kumar lyer

  1. Nutrition in Renal Diseases-

                                                                                                       Sanjay Gupta

  1. Nutrition in Inflammatory Bowel Disease

                                                                                                       Jaya Benjamin

  1. Nutritional Management of Celiac Disease-

                                                                                        Shinjini Bhatnagar, Anuja Aggarwala, Pawan Kumar

  1. Nutritional Support in Liver Disease

                                                                                         YK Joshi, Nandini Srivastava, Namrata Singh

  1. Nutritional Management of Pancreatitis-

                                                                                        YK Joshi, Namrata Singh, Shallu Midha

  1. Nutrition in Surgery-

                                                                                        Sudershan Ballal

  1. Diet Therapy in Diabetes Mellitus

                                                                                         Rekha Sharma, Swapna Chaturvedi

  1. Nutritional Management in Cancer Patients

                                                                                         KM Mohandas

  1. Nutritional Support in Geriatrics

                                                                                          K Sriram

  1. Probiotics

                                                                                          Kumar Kirti

  1. Antioxidants

                                                                                          Payal Bhardwaj

  1. Immunonutrition

                                                                                           YK Joshi

  1. Role of a Nurse in Nutritional Management

                                                                                           Swapna Naskar Williamson, Mala Goswami

  1. Methods of Food Preparation

                                                                                           Sandhya Kumar

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